Tragically, the spill occurred just upstream from West Virginia American Water’s primary intake, treatment and distribution center. The location of the spill resulted in contaminated water reaching ~300,000 citizens, representing nine counties in the Charleston, WV, metropolitan area.

Following the Spill, investigations determined that MCHM likely poses few health concerns, in the diluted amounts people in the area encountered, but this was determined only after its release into public waters. In addition, the spill itself, and related policy actions (e.g., passage of WV SB 373) highlighted critical health and safety concerns, especially regarding above-ground chemical holding tanks like the one that leaked MCHM into the Elk River, and instituted robust regulatory solutions. This was short lived, however; several years post-Spill, WV SB 423 was passed, which eased/erased WV SB 373’s stricter regulations.

In 2018, filmmaker Cullen Hoback, released the exposition piece What Lies Upstream; the documentary details the Elk River Spill and presents shocking evidence of health and safety laws (e.g., WV SB 423) being written by the corporate entities the laws are intended to monitor and regulate (specifically West Virginia American Water and Eastman Chemical Co.) and subsequently voted into law by (evasive) politicians who seem never to have even read the corporate-drafted documents being sponsored.

In light of these revelations I implore concerned citizens to contact and support West Virginia clean water advocacy groups like the West Virginia Rivers Coalition, and subject matter experts like Drs. Andy Whelton and Marc Edwards, both featured in What Lies Upstream, in their attempts to repeal WV SB 423 and reinstate more rigorous health and safety regulations in WV SB 373.

CNMI college students educate children and their parents on sugar content in commonly purchased beverages at a community event in 2016. Credit: Kaitlyn Neises-Mocanu

Factors which determine our health include the environments in which we live, work and play: these factors exist outside the clinic walls and beyond the range of our public health services. Improving the health of our population in the Commonwealth of the Northern Mariana Islands (CNMI) requires an environment which supports healthy choices.

Inflatable Coca-Cola advertisement at the same community event photographed above. Credit: Kaitlyn Neises-Mocanu

We are inundated by a “culture” of sugary drinks created by the beverage industry, promoting the over-consumption of sugary drinks. According to the 2016 CNMI Non-Communicable Disease and Risk Factor survey, nearly three out of four (74.1%) CNMI adults drink at least one sugar-sweetened beverage every day.

If we expect our neighbors to make healthy lifestyle choices, the healthy choice needs to be the easy choice. When unhealthy beverages are cheap, deceptively marketed, and dominate beverage coolers at every mom and pop store, we make drink choices at the cost of our own health. A tax on sugar-sweetened beverages brings down consumption levels, incentivizes distributors and retailers to stock healthier beverage options, and has the potential to change beliefs, attitudes and norms about sugary drink consumption.

Source: 2016 CNMI NCD Risk Factor and Behavior Survey

As an added benefit, a tax on sugary drinks raises much-needed revenue for diabetes prevention and management programs, opens up a funding resource for local groups who want to improve health in their communities, and supports the CNMI’s only hospital.

Our government is responsible for protecting the health of the public, and when products which detriment our health, like sugary drinks, are heavily marketed and sold cheaply in our community, action must be taken. Encourage CNMI Legislators to send the message that the health of our people is a priority, and urge them to take action to increase the tax on sugary drink distribution.

The Clean Power Plan enacted in 2015 aimed to reduce greenhouse emissions from the energy sector, which account for almost 40% of the U.S. carbon dioxide emissions, necessary to halt the predicted destructive impact climate change will have globally. In March 2017, President Trump signed the Executive Order for Energy Independence, which sent the policy for review by the EPA to either withdraw or rewrite the plan, a lengthy process which will halt the policy’s regulation of power plant emissions.

The Clean Power Plan and all other actions to reduce climate change are necessary for all countries and individuals globally. Coastal cities, such as Miami, are already dealing with flooding due to the sea level increasing.

Individually, people should care for their health. Energy production from coal leads to air pollution and climate change creating or worsening respiratory problems such as asthma, bronchitis, emphysema, and lung cancer, as well as increasing the risk of heart attack, heart failure, and stroke. The length of allergy seasons has already increased, for example the ragweed season is 21 days longer than in 1995.

Minnesota itself has not hit the emission targets set to reduce the impact of climate change, while the rest of the country has variable progressions. In Minnesota, we need to be advocates for our health and wellbeing, and to do so, we must encourage others to support the Clean Power Plan and other efforts to combat climate change and turn our focus and investment to more efficient or cleaner forms of energy.

Suicide ranges among the leading causes of death in Nepal. According to the World Health Organization, Nepal’s suicide rate ranked 7th in the world with 25 suicides per 100.000. Nepalese women even made a worrisome 3rd place in 2012. Living conditions for women are especially difficult due to gender discrimination, childhood marriage, low education and economic hardship. The Government of Nepal emphasizes the need to tackle mental health issues but has yet to elaborate a specific national strategy for suicide prevention.

WHO recommends restricting the access to means of self-harm/suicide as “a key element of an evidence-based population-level strategy to prevent suicide”. Studies have found that pesticide ingestion is the commonest method of attempting suicide, probably resulting from the practice of storing pesticides at home for agricultural use. Nepal’s Pesticide Act of 1991 envisioned a national council on pesticides which was never implemented. National policies that restrict the imports and sales of toxic pesticides have had a major impact on suicides, as prior experience in Sri Lanka has shown.

However promising, a law banning or restricting highly toxic pesticides may be a toothless tiger as means of enforcement, such as fines or taxation, can easily be undermined. Different, “less toxic” but nonetheless poisonous substances may be imported and sold. Profitable and effective domestic food production is essential to farmers and the population, which meets the interest of the pesticides industry to establish new markets. Guidance is offered by the International Labor Organization (ILO). In 2013, the ILO and the Government of Nepal signed the Decent Work Country Program for Nepal to improve work conditions, safety, and health protection.

Conclusion

A national policy on pesticides should aim at eliminating the most problematic pesticides. But replacement pesticides must be offered as well as non-chemical and biological agents along with education and training (Integrated Pest Management). This can only be achieved through a concerted effort of all stakeholders – WHO, ILO, the Government, Farmers and business associations and the Pesticides Industry.

Not only means to commit suicide would be tackled: decent working and living conditions strengthen the individuals’ feeling of self-worth and hereby grasp suicidality by some of its own roots.

Antimicrobial resistance (AMR) can arise from inappropriate use of antimicrobial medications (AMMs). In the United States, more than 80% of all AMMs are used in food animal production, including classes of medications that are on the WHO list of critically important AMMs. Prior to 2017, many AMMs for food animal production could be purchased and used without a prescription and for purposes such as “growth promotion,” rather than for treating a documented infection.

In 2012 and 2013, the FDA released Guidance for Industry, which sought to define judicious use of AMMs in food production, as well as to recommend that the animal pharmaceutical industry voluntarily change their labeling of critically important AMMs used in food production. In short, the FDA recommended that certain AMMs should no longer be used without veterinary oversight or solely for “growth promotion.” Using these medications against their labelled purposes would then constitute a violation of the Federal Food, Drug, and Cosmetic Act.

Despite pushback from industry groups such as the National Pork Producers Council and the National Turkey Federation, which argue that there is no firm science supporting the concept that AMMs in animal production result in AMR in humans, the FDA has shown some early successes of their new guidelines. According to reports published this year, the pharmaceutical industry voluntarily either changed all new drug applications to require veterinary oversight or withdrew the applications from consideration by January 2017. Credit: wellnesswarrior.org

However, there is more work to be done. Further guidance from the FDA should tighten controls on the use of AMMs in food production for disease prevention purposes. Currently, use of AMMs for disease prevention can includeprophylactic administration of subtherapeutic doses for prolonged periods, dosed imprecisely in feed or water, to entire herds or flocks. Additionally, organizations focused on veterinary medicine and animal care, such as the USDA, should be made part of the Transatlantic Task Force on Antimicrobial Resistance (TATFAR). Finally, improved animal husbandry in food production facilities (decreased crowding, improved sanitation) would lead to less infectious disease.

Kiribati, a small Pacific island nation, could disappear under water in a few decades due to climate trends. Former President Anote Tong led initiatives to address climate change effects, such as the Kiribati Adaptation Program . This World Bank-funded program helped to provide education and infrastructure support to help the country manage the threat of climate change but only through 2016. It is now crucial for the current Kiribati administration to continue this progress and introduce a formal policy to mitigate the effects of climate change and preserve this beautiful country.

Key stakeholders support efforts to curtail climate change. The United Nations has increased international attention on climate change effects in Kiribati. International businesses such as Sunlabob Renewable Energy and Kiribati Fish Ltd. are using natural resources to create training and economic opportunities. There is grassroots support for environment protection from NGOs such as the Kiribati Climate Action Network. However, skepticism exists among various entities. Current President Taneti Maamau places lower priority on climate change than the former president did . Even the pastor with the Kiribati Uniting Church, serving almost half of the country’s population, does not fully believe in these effects.

There should be no doubt that climate change can affect the wellbeing of all Kiribati people. We must petition Parliament to introduce a bill that shifts funding toward climate change mitigation programs focusing on international advocacy, education, and local economic support with signature of President Maamau. Tebao Awerika, Minister of Environment, Lands, and Agricultural Development, and Dr. Teuea Taotu, Minister of Finance and Economic Development, can provide testimony to Parliament and strengthen our advocacy efforts. This government must be a part of actionable change to save lives and maintain the wellbeing of Kiribati citizens.

Image of Agbogbloshie from David Fedele’s award-winning film, E-Wasteland

eWaste workers across Ghana feel they have a choice: suffer the poverty of joblessness or face the poison of informal ewaste processing. This awful choice is partly driven by the informal nature of the sector. It is time for the Government of Ghana to step up with a policy to compel the ewaste processing industry to protect worker and community health. A strong policy to protect health will encourage more sustainable growth for the bourgeoning industry and will ensure more Ghanaians reap the benefits of industrial growth. And a strong policy begins with an inclusive taskforce.

eWaste and Livelihoods: Processing of ewaste includes collection, repair, refurbishment, recycle and disposal management. The industry makes a substantial contribution to Ghanaian livelihoods – it is estimated that the industry employs almost 1% of the Ghanaian population, with workers earning US$70-285/month. The ewaste industry is projected to continue growing with annual increases in e-waste generation of 5–10% (Ghana EPA, 2015).

eWaste and Health: Research based in Agbogbloshie (the epicenter of Ghana’s ewaste industry), reveals that the risk of exposure to toxic chemicals is very high for surrounding communities. This risk is amplified by the fact that ewaste processing is collocated with an active market and other civic buildings. And the risks for workers – including children – are even higher. A case-control study collected urine and blood samples that demonstrated that ewaste workers suffer measureable adverse health outcomes as a result of exposure to heavy metals in their occupation.

Avoiding Poverty and Poison: There are successful pilot programs – like the eWaste Recycling Center in Agbogbloshie – that demonstrate that it is possible to reap the financial benefits while avoiding the health costs of ewaste processing. And there are some policy efforts to scale-up healthy operations (see EPA’s proposed bill). The next step to implementing a strong policy is to establish an inclusive taskforce – with representation from ewaste processors (both formal and informal), relevant nonprofits and perhaps international electronics producers – to advise on acceptable and effective policy options.

As people start to come to terms with the serious health impacts of climate change, there is a strong push for climate change mitigation through policy. The carbon tax is one such policy intervention that holds promise for reducing the amount of greenhouse gases in Earth’s atmosphere by putting a direct price on carbon. By putting a price on carbon, we can improve the economy, reduce health impacts from global warming, and reduce pollution that results in global warming.

A federal carbon tax in the US would put a price on each tonne of CO2 emitted and provide financial incentives to businesses, governments, communities, and individuals to use less carbon, and a financial penalty for those who use more. The tax would include hidden carbon costs of a service or product (e.g. transportation costs) as well as direct costs involved in production or service delivery.

Many other countries already have a version of a carbon tax in place, including British Columbia, Chile, Costa Rica, Denmark, Finland, France, Iceland, Ireland, Japan, Mexico, Norway, South Africa, Sweden, Switzerland, and the United Kingdom. Now it is time for the US to become a leader in the climate change fight and join the rest of the world to reduce our carbon emissions!

While groups such as the Citizens’ Climate Lobby, Physicians for Social Responsibility, the US Environmental Protection Agency, and even oil and gas companies such as Exxon Mobil have come out in support of taxing carbon, there are still some groups who are against it, such as many individuals and business with ties to the oil, coal, and gas sectors; as they stand to pay more penalties for producing carbon-based products. Some organizations; such as the Union for Concerned Scientists, are against the tax- not because they think it is a bad idea, but because they support the idea of a cap and trade system (where there is a mandatory limit on emissions, but businesses can have flexibility about how they comply) instead.

Climate change has been highly polarized in US politics with many conservatives arguing against the tax while many liberals support the tax, but even some conservatives such as Jerry Taylor (Libertarian) advocate for the tax and give strong arguments for conservative support (read it here). Currently, there is a proposal to pass a carbon tax in Washington, making it the first state to adopt a carbon tax. Although opponents claim that a carbon tax may hurt the economy, this has not been shown to be the case in countries that have already adopted a carbon tax. For example, British Columbia has used the revenue from the carbon tax to help strengthen their economy. As you can see below, petrol sales also have gone down since the tax was introduced in 2008.

If you want to show your support for the carbon tax:

Vote for representatives who support the carbon tax and other related climate change policies

Support organizations who show support for the tax

If your state happens to draft carbon tax legislation, call your congressperson or start a petition to show your support

Household air pollution (HAP), caused by burning unclean fuels such as wood, dung, crop residue, coal, and kerosene indoors for cooking and heating, is a serious threat to health. Household use of coal releases toxic emissions that lead to lung cancer and chronic obstructive pulmonary disease. Burning kerosene indoors also releases harmful emissions that can cause cancer, respiratory diseases, allergies, and cataracts. Because of these dangers, the World Health Organization (WHO) recently released “Indoor Air Quality Guidelines” recommending that countries ban the household use of coal and kerosene.

This recommendation needs to be considered in Nepal, where household air pollution is the number one cause of death and disability.

Key determinant involving in this problem is oil contamination. A large number of oil spills with an estimate of 1.5 million tons over a period of 50 years resulting in oil contaminated water which is dangerous for use. The primary stakeholders of this problem involved various arms including the Nigerian Federal and State Government, local media, oil corporations, and organization such as United Nations Environment Programme (UNEP).

We propose a policy to create accountability for the oil corporations to prevent oil contamination to water in this region. We suggest drafting and passing the bill that will mandate the oil companies to be financially responsible for the engineering and infrastructure costs of building and maintaining the facility to improve oil contamination. The government needs to regulate and implement the strategy. We also support the use of media to direct this message to the people of Niger Delta.

We are relying on the those stakeholders to come together and ensure the proposed policy takes hold. It is a step toward restoring health and well being to the people of the Niger Delta region.